ICSS, Youth Group, Hebrew School Registration

Guardian 1 Name

Guardian 1 Phone Number

* Guardian 1 Email

Guardian 1 Address Line 1

Guardian 1 Address Line 2

Guardian 2 Name

Guardian 2 Phone Number

Guardian 2 Email

Guardian 2 Address Line 1

Guardian 2 Address Line 2

* Emergency Contact Name

* Emergency Contact Phone Number

Child 1 Name

Child 1 School

Child 1 Grade (2019-2020 Year)

Please list/describe any relevant medical (including food allergies), developmental, or learning conditions concerning your child.

Child 2 Name

Child 2 School

Child 2 Grade (2019-2020 Year)

Please list/describe any relevant medical (including food allergies), developmental, or learning conditions concerning your child.

Child 3 Name

Child 3 School

Child 3 Grade (2019-2020 Year)

Please list/describe any relevant medical (including food allergies), developmental, or learning conditions concerning your child.

Child 4 Name

Child 4 School

Child 4 Grade (2019-2020 Year)

Please list/describe any relevant medical (including food allergies), developmental, or learning conditions concerning your child.

Medical Emergency I grant my authorization and consent for Temple B'nai Israel to summon professional emergency personnel to attend, transport, and treat my student and to issue consent for any medical treatment. I agree to assume financial responsibility for all expenses of such care. PLEASE SIGN

Can we take photos and videos of your child to post on Temple bulletins, newsletters and social media? YES OR NO

ICSS Registration (Per Child) - $275

Hebrew School Registration (Per Child) - $290

Club 54 Youth Group (For 4th and 5th Graders) - $18

JR OKATY Youth Group (For 6th-8th Graders) - $18

OKATY Youth Group (9th-12th Graders) - $54

Total Youth Registration

Fri, April 26 2024
18 Nisan 5784

Upcoming events

Fri, April 26 2024 18 Nisan 5784